MEDICARE: FTP MRI RADIOLOGY, PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2085R0202X	Diagnostic Radiology Physician

General Provider Information

NPI Number	:	1538925615
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FTP MRI RADIOLOGY, PLLC

Provider Business Mailing Address
First Line	:	PO BOX 242848
Second Line	:
City	:	MONTGOMERY
State	:	AL
Zip	:	36124-2848
Country	:	US
Telephone Number	:	334-270-9914
Fax Number	:	334-270-3195

Provider Business Practice Location Address
First Line	:	1110 GLENN BLVD SW STE B
Second Line	:
City	:	FORT PAYNE
State	:	AL
Zip	:	35967-8486
Country	:	US
Telephone Number	:	256-845-9402
Fax Number	:	256-845-9410

Authorized Official
Title or Position	:	OWNER
Name	:	ROSS W BARNETT
Credential	:	MD
Telephone Number	:	334-271-6736

Provider Enumeration Date	:	02/26/2024
Last Update Date	:	02/26/2024

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